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When first encountering the multifaceted array of hearing evaluations and screenings, it’s not uncommon to feel lost and overwhelmed. An online search on the topic will invariably supply endless pages for “online hearing tests” and diverse references to in-person evaluations. While online tests can be a helpful way to gauge if one should seek further help with his or her hearing, there remains no fair replacement for the detailed and individualized analysis and treatment that patients receive from in-person hearing evaluations.

Take a look at the types of tests hearing professionals use to precisely measure the best solution for their patients.

Hearing Screenings

Sometimes misunderstood as hearing evaluations or tests, hearing screenings are actually in a category of their own. Hearing screenings are most commonly seen in hospitals, for newborn babies, and at schools, for elementary-age children. Unlike actual hearing tests, screenings are not at all diagnostic. When someone doesn’t pass a hearing screening, he or she then moves on to get a full hearing evaluation to verify and diagnose the presence and type of hearing loss.

Physical Exam

No matter how advanced online hearing tests have become, this is one area of testing that it has yet to master. The physical exam is usually the first part of an in-person hearing test, and it’s an important one. In some cases, the cause of hearing loss is as simple as impacted cerumen (earwax) deep in the canal. Taking an online hearing test in this situation would result in the person believing that she or he qualified for hearing aids, when really, a simple professional ear cleaning would solve the problem.

The physical ear exam involves your hearing professional using a tool called an otoscope to help them magnify and light up your ear canal. Some offices use a otoscopic camera which places a visual of your canal and ear drum on a screen for both you and your hearing professional to examine and discuss. The ear canal and ear drum are then scanned for any damage or impacted debris, and cleaned out if necessary.

Air Conduction Test

This test is one of the three basic tests done for all audiological evaluations, and is considered the first part of a two part “tone test.” It involves a series of beeps and whistling sounds at varying volumes and pitches, where the patient is instructed to indicate when they hear a sound (either by signaling to the hearing professional or by clicking their keyboard for online versions). Since the sounds in this test are “pure tones,” as they are a single frequency each, they help clarify which sound frequencies the patient can no longer hear. It is performed on one ear at a time and serves to test the sensitivity of the entire hearing organ.

Bone Conduction Test

This is the second part of the “tone test” series, and involves a hearing professional putting a bone-conduction vibrator behind the patient’s ear, and then having the patient listen for pure tones as done in the Air Conduction Test, but without earphones. The vibrator is placed directly on the mastoid bone behind the ear and sound is actually transmitted through the bones directly into the inner ear.

Bone Conduction tests are only done when the previous Air Conduction test revealed some degree of hearing loss, and helps to determine if the source of hearing loss is due to a physical issue within the outer or middle ear, known as “conductive” hearing loss.

Speech Recognition Test

After the tone tests, the ability to register speech is tested. This can be done with earphones or speakers, and is typically tested with and without competing background noise. The patient is asked to repeat the words they are hearing to determine the faintest volume threshold he or she can decipher.

Impedance/Admittance Test (Tympanometry)

This tests the middle ear’s ability to transmit sound vibrations to the inner ear. A machine called a tympanometer measures how well the eardrum moves back and forth in response to air pressure changes, and also helps to diagnose any fluid build up in the middle ear. If there is any congestion between the middle ear and throat, which would affect hearing, this test will identify it.

Acoustic Reflex Test

Performed when necessary, this test evaluates the ability of the small muscles in the middle ear to contract in response to loud sounds. It reveals the functioning capacity of the inner ear, auditory nerve and facial nerve.

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